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Biomedical subjects

Thomas Boehm

Publications and source records attributed to Thomas Boehm.

At least 37 records · Page 2Linked to original sources
PubMed2005

Benefit of echocontrast-enhanced transcranial arterial color-coded duplex ultrasound.

OBJECTIVES: Proper assessment of the intracranial arteries by transcranial color-coded duplex sonography (TCCD) is occasionally made difficult by an insufficient temporal bone window, an unfavorable insonation angle, or low flow velocity or volume. In these cases, echocontrast could be helpful to increase the diagnostic confidence or to make the diagnosis at all. MATERIAL AND METHODS: We investigated 67 temporal windows of 47 patients with insufficient native transtemporal insonation conditions before and after the application of the second-generation (gas-filled) microbubble contrast agent Sonovue (in 20 patients out of these 47, both temporal windows were insufficient, in the remaining 27 only one side). RESULTS: As compared to the precontrast scans, echocontrast allowed for more segments to be evaluated by pulsed Doppler sonography (p < 0.0001) and for longer lumen segments to be displayed on color mode (p < 0.0001). With the help of contrast medium, flow velocity in the middle cerebral artery could be measured through 65 windows as compared to only 26 windows before contrast was applied (p < 0.0001). CONCLUSIONS: In patients with poor precontrast visualization of intracranial arteries, echocontrast-enhanced TCCD is very helpful.

Adult↗
PubMed2005

Mate choice decisions of stickleback females predictably modified by MHC peptide ligands.

Sexual selection has been proposed as one mechanism to explain the maintenance of high allelic diversity in MHC genes that control the extent of resistance against pathogens and parasites in natural populations. MHC-based sexual selection is known to involve olfactory mechanisms in fish, mice, and humans. During mate choice, females of the three-spined stickleback (Gasterosteus aculeatus) use an odor-based selection strategy to achieve an optimal level of MHC diversity in their offspring, equipping them with optimal resistance toward pathogens and parasites. The molecular mechanism of odor-based mate-selection strategies is unknown. Because peptide ligands for MHC class I molecules function as individuality signals in mice, we hypothesized that female sticklebacks might assess the degree of MHC diversity of potential partners by means of the structural diversity of the corresponding peptide ligands in perceived odor signals. We show that structurally diverse MHC ligands interact with natural odors of male sticklebacks to predictably modify MHC-related mate choice. For a mating pair with suboptimal numbers of MHC alleles, peptides increase the attractiveness of male water, whereas for a mating pair with superoptimal numbers, attractiveness is decreased. Our results suggest that female sticklebacks use evolutionarily conserved structural features of MHC peptide ligands to evaluate MHC diversity of their prospective mating partners.

Amino Acid Sequence↗
PubMed2005

Cardiac arrest in a soccer player: a unique case of anomalous coronary origin detected by 16-row multislice computed tomography coronary angiography.

Anomalous origin of the coronary arteries may be present in otherwise normal subjects without clinical significance, but can also be the cause of myocardial ischemia and sudden death in both adults and teenagers. In particular, the origin of the left main coronary artery or left anterior descending artery from the right sinus of Valsalva or right coronary artery may result in compression of the vessel during or immediately after exercise. We present a unique case of coronary anomaly with four separate coronary ostia originating from the right coronary sinus in a soccer player with sudden cardiac arrest. Multislice contrast-enhanced computed tomography has emerged as a valid noninvasive method for the diagnosis of coronary artery anomaly.

Coronary Angiography↗
PubMed2005

Coarctation and aorto-aortic bypass: three-dimensional post-processing using multidetector row computed tomography.

We present the case of a 61-year-old man with a history of dyspnea and disparity in blood pressure of the arms and legs due to a stenotic biscupid aortic valve and a hemodynamically relevant restenosis of a resected coarctation. The coarctation was treated with an extra-anatomic transdiaphragmal aorto-aortic bypass graft. At the same time, the biscupid aortic valve was replaced. Postoperative follow-up contrast-enhanced multidetector row computed tomography (MDCT) and three-dimensional (3D) postprocessing of the axial data sets using the volume-rendering technique was performed. This case of complex vascular structures demonstrates the potency of MDCT combined with the 3D visualization technique.

Aortic Coarctation↗
PubMed2005

Image quality of volume rendering of the bronchial tree: Kymogram-gated versus retrospectively ECG-gated and non-gated multi-row detector CT.

RATIONALE AND OBJECTIVE: To compare the image quality of three different heart-cycle-synchronized computed tomography (CT) reconstruction algorithms for volume-rendered (VR) 3D visualization of the bronchial tree. MATERIALS AND METHODS: Kymogram-gated, retrospectively ECG-gated, and non-ECG-gated reconstructions of the bronchial tree were performed from 4-detector-row CT data in 10 subjects. The raw data were reconstructed in 10 phases of the cardiac cycle using ECG-gated and kymogram-gated technique, respectively. For both reconstructions, the optimal artifact-free diastolic phase was determined. VR reconstructions of the bronchial tree were generated from these two data sets and from the non-gated data. Stairstep artifacts of the main bronchi, artifacts in the lung parenchyma, and the extent of bronchial tree visualization were rated by two blinded, independent readers. RESULTS: Kymogram-gated reconstruction showed stairstep artifacts in the main bronchi to the same extent as non-gated reconstruction, but less compared to ECG-gated reconstruction (P < .001). Artifacts in the lung parenchyma were similar with kymogram-gated and non-gated reconstruction, but less compared to ECG-gated reconstruction (P < 0.01). Kymogram-gated reconstruction showed no differences in visualization of segmental and subsegmental bronchi compared to ECG-gated reconstruction, but was inferior to the non-gated reconstruction (P < 0.05). CONCLUSION: Kymogram-gated reconstruction of CT data results in fewer artifacts when compared to the ECG-gated algorithm. Best visualization of the bronchial tree at a low artifact level is obtained with non-gated CT data. It remains therefore the method of choice for VR 3D data post-processing of the bronchial tree.

Adult↗
PubMed2005

Dynamic cine mode imaging of the normal aortic valve using 16-channel multidetector row computed tomography.

BACKGROUND: We investigated the feasibility and image quality of dynamic cine-mode imaging of the normal aortic valve using multidetector row computed tomography (MDCT). MATERIALS AND METHODS: We acquired contrast-enhanced retrospectively echocardiography (ECG)-gated cardiac MDCT datasets of 35 patients (mean age, 62 years; range, 53-77) who received a transoesophageal echocardiography (TOE) precedent to cardiac bypass graft surgery. Twenty data sets in 5% steps of the R-R interval were reconstructed, and data analysis was performed using a 4D software. Read-out of the MDCT data was performed in parallel and perpendicular planes, similar to TOE standard planes, by 2 independent, blinded readers using a 4-point Likert scale (best score: 4) for the following parameters: image quality of the aortic valve components, contrast media enhancement, contrast media inflow related artifacts, and ECG gating-related artifacts. The aortic valve area (AVA) was measured planimetrically and was compared between TOE and MDCT. RESULTS: The best phase for assessing the open valve using MDCT was at 5% and the closed valve at 65% of the cardiac cycle. The mean image quality scores for cine-mode MDCT ranged between 3.26 and 3.75, with inter-reader agreements ranging between good (kappa = 0.723) and excellent (kappa = 1.00). They did not differ significantly from TOE scores for assessment of the closed and open valve. In transitional phases (close-to-open and open-to-close) TOE performed significantly better when compared with static MDCT images, whereas no significant difference was present between cine-mode presentation of MDCT and TOE. Planimetric AVA measurements correlated significantly between TOE and MDCT (Pearson correlation coefficient, r = 0.96; P < 0.0001). Contrast media inflow-related and ECG gating related artifacts were rated as slightly compromising (scores 3.24 and 3.21). CONCLUSION: Retrospectively ECG-gated MDCT offers a noninvasive, accurate, and dynamic imaging method for quantitative and qualitative evaluation of the normal aortic valve allowing determination of morphology and function throughout the cardiac cycle. Further studies regarding assessment of diseased valves are necessary.

Aged↗
PubMed2005

Sixteen-detector row CT angiography for lower-leg arterial occlusive disease: analysis of section width.

Institutional review board approval and written informed consent from all patients were obtained. Diagnostic accuracy of three reconstructions of 16-detector row computed tomographic (CT) angiography data with different section widths and increments (2.0 and 1.0 mm [CT data set 1], 1.0 and 0.5 mm [CT data set 2], and 0.75 and 0.4 mm [CT data set 3]) was compared with that of digital subtraction angiography (DSA) in 163 arterial segments in 17 patients with occlusive peripheral arterial disease (PAD). Arterial visibility was superior with CT as compared with DSA (P < .008). Sensitivity for stenosis detection did not differ between the CT reconstructions, whereas specificity was significantly improved when CT data set 3 was used (P < .017). Stenosis length did not differ significantly between CT angiography and DSA. Accuracy of stenosis detection was 88.2%, 90.8%, and 96.1% with CT data sets 1, 2, and 3, respectively. CT angiography has excellent diagnostic accuracy in the assessment of lower-leg PAD provided that the thinnest possible section width is used.

Aged↗
PubMed2005

Dynamic cine imaging of the mitral valve with 16-MDCT: a feasibility study.

OBJECTIVE: Our aim was to assess the feasibility and image quality of dynamic cine-mode imaging of the mitral valve using retrospectively ECG-gated 16-MDCT. SUBJECTS AND METHODS: Contrast-enhanced MDCT was performed in 37 patients who have a normal mitral valve, as shown on transesophageal echocardiography. Twenty CT data sets covering the valve apparatus were reconstructed every 5% step of the R-R interval. Multiplanar reconstructions were performed in the parallel short axis and perpendicular long axis of the left ventricle. Two independent blinded reviewers evaluated the image quality for dynamic cine-mode visualization of the valve components in systole and diastole and during the transitional phases in between. RESULTS: Interobserver agreement for image quality ratings of valve components in all cardiac cycle phases ranged from good to excellent. Image quality for the visualization of valve leaflets, apposition zone, commissures, and mitral annulus (ranging from adequate to excellent) was significantly superior on perpendicular plane images than on parallel plane images for all cardiac phases (p < 0.05). Tendinous cords were visualized on both perpendicular and parallel planes with bad to adequate quality, whereas visualization of the papillary muscles was adequate to excellent on both imaging planes. Visualization of each valve component was superior in systole and diastole in both imaging planes as compared with the transitional phases (p <0.001). CONCLUSION: Noninvasive cine-mode imaging of the mitral valve using retrospectively ECG-gated MDCT is feasible and allows accurate visualization of the moving valve. Perpendicular long-axis reconstructions yield images of superior quality when compared with the short-axis reconstructions and enable a determination of its functional morphology.

Aged↗
PubMed2004

MHC class I peptides as chemosensory signals in the vomeronasal organ.

The mammalian vomeronasal organ detects social information about gender, status, and individuality. The molecular cues carrying this information remain largely unknown. Here, we show that small peptides that serve as ligands for major histocompatibility complex (MHC) class I molecules function also as sensory stimuli for a subset of vomeronasal sensory neurons located in the basal Gao- and V2R receptor-expressing zone of the vomeronasal epithelium. In behaving mice, the same peptides function as individuality signals underlying mate recognition in the context of pregnancy block. MHC peptides constitute a previously unknown family of chemosensory stimuli by which MHC genotypic diversity can influence social behavior.

Action Potentials↗
PubMed2004

Coronary artery bypass grafts: ECG-gated multi-detector row CT angiography--influence of image reconstruction interval on graft visibility.

PURPOSE: To evaluate the influence of different reconstruction intervals of retrospectively electrocardiographically (ECG)-gated multi-detector row computed tomographic (CT) angiography on image quality of different segments of various types of coronary artery bypass grafts. MATERIALS AND METHODS: Twenty consecutive patients with 62 grafts underwent retrospectively ECG-gated four-channel multi-detector row CT angiography and conventional coronary angiography. Raw helical CT data were reconstructed at 0%-90% of the cardiac cycle in increments of 10%. Each graft was separated into three segments (proximal segment, graft body, and distal anastomosis). Three graft types were identified according to site of distal anastomosis. Two readers assessed image quality of segments and graft types. Effective radiation dose was calculated. RESULTS: Best image quality of all segments was obtained at a reconstruction interval of 50%-70% of the cardiac cycle. Image quality of the proximal segment did not vary significantly with different reconstruction intervals (analysis of variance, P =.8), whereas image quality of the graft body and distal anastomosis changed significantly with varying reconstruction intervals (P <.001). Distal anastomosis and body of types 1 and 2 grafts were best seen at 60%-70% of the cardiac cycle, whereas distal anastomosis and body of type 3 grafts were best visualized at 50%. Accuracy of CT angiography for detection of graft patency was 94% for reader 1 and 95% for reader 2. Effective dose for CT was 11.4 mSv for both men and women. Mean effective dose for angiography was 2.1 mSv for men and women. CONCLUSION: Optimal selection of reconstruction interval improves image quality of the graft body and of distal anastomosis in particular.

Aged↗
PubMed2004

Evaluation of radiological workstations and web-browser-based image distribution clients for a PACS project in hands-on workshops.

The methodology and outcome of a hands-on workshop for the evaluation of PACS (picture archiving and communication system) software for a multihospital PACS project are described. The following radiological workstations and web-browser-based image distribution software clients were evaluated as part of a multistep evaluation of PACS vendors in March 2001: Impax DS 3000 V 4.1/Impax Web1000 (Agfa-Gevaert, Mortsel, Belgium); PathSpeed V 8.0/PathSpeed Web (GE Medical Systems, Milwaukee, Wis., USA); ID Report/ID Web (Image Devices, Idstein, Germany); EasyVision DX/EasyWeb (Philips Medical Systems, Eindhoven, Netherlands); and MagicView 1000 VB33a/MagicWeb (Siemens Medical Systems, Erlangen, Germany). A set of anonymized DICOM test data was provided to enable direct image comparison. Radiologists ( n=44) evaluated the radiological workstations and nonradiologists ( n=53) evaluated the image distribution software clients using different questionnaires. One vendor was not able to import the provided DICOM data set. Another vendor had problems in displaying imported cross-sectional studies in the correct stack order. Three vendors (Agfa-Gevaert, GE, Philips) presented server-client solutions with web access. Two (Siemens, Image Devices) presented stand-alone solutions. The highest scores in the class of radiological workstations were achieved by ID Report from Image Devices ( p<0.005). In the class of image distribution clients, the differences were statistically not significant. Questionnaire-based evaluation was shown to be useful for guaranteeing systematic assessment. The workshop was a great success in raising interest in the PACS project in a large group of future clinical users. The methodology used in the present study may be useful for other hospitals evaluating PACS.

Computer Communication Networks↗
PubMed2004

Major shifts in genomic activity accompany progression through different stages of the hair cycle.

Hair follicles display a unique pattern of cyclic growth and regression involving cell proliferation, differentiation and migration. The molecular details of these processes are largely unexplored. Global expression analyses on the basis of about 20,000 genes for each morphologically distinguishable stage of the hair cycle revealed unexpected complexities of and major temporal shifts in transcriptional programs involving about 13% of all genes. In particular, hundreds of genes characterise the pattern of genomic activity during regression and resting phases; selected genes can be used to monitor hair growth in mice. We demonstrate that temporal expression patterns predict gene expression domains within the hair follicle. Expression of insulin-like growth factor binding proteins and anti-angiogenic factors is associated with the regression phase of the hair cycle.

Angiogenesis Inducing Agents↗
PubMed2004

Capn5 is expressed in a subset of T cells and is dispensable for development.

The Capn5 gene was inactivated by homologous recombination in ES cells that subsequently colonized the germ line of mice. The targeted mutation integrated a lacZ expression cassette into the Capn5 gene, allowing the expression of Capn5 mRNA to be examined in detail in heterozygous animals. Expression was observed in embryonic and newborn thymuses, in various epithelial tissues, and in tissues of the central nervous system. In the thymus, Capn5 was expressed mainly in relatively immature CD25(+) embryonic thymocytes. Despite the numerous expression sites of Capn5, the majority of Capn5-null mice were viable and fertile and appeared healthy. Histopathological analysis did not reveal any differences between Capn5-null and wild-type mice. There were no defects in the major T- or B-cell populations in the thymus, spleen, bone marrow, or peritoneum, nor did apoptosis appear abnormal in Capn5-null T cells. There was no evidence for the development of autoimmune disease in Capn5-null animals. However, a small proportion of homozygous null offspring from heterozygous matings were runted and most often did not survive to adulthood.

Alleles↗
PubMed2004

Effects of ECG gating and postprocessing techniques on 3D MDCT of the bronchial tree.

OBJECTIVE: Our goal was to determine the impact of ECG gating and different postprocessing techniques on 3D imaging of the bronchial tree. SUBJECTS AND METHODS. Retrospective ECG-gated MDCT and non-ECG-gated MDCT of the chest were performed in 25 patients. ECG-gated MDCT data were reconstructed mid diastole using a fixed interval of -400 msec in 25 patients and then additionally at -200, -300, and -500 msec in 10 of those patients. Shaded surface display and volume rendering of the bronchial tree combined with virtual bronchoscopy were performed using all data sets. The extent of bronchial tree visualization in shaded surface display-virtual bronchoscopy and volume rendering-virtual bronchoscopy and the presence of artifacts in volume-rendered images were scored by three blinded reviewers. The effective radiation doses of the ECG-gated and nongated acquisitions were compared. RESULTS: The summary scores of all bronchial segments for gated shaded surface display-virtual bronchoscopy and gated volume rendering-virtual bronchoscopy did not differ significantly. The summary scores for nongated shaded surface display-virtual bronchoscopy and nongated volume rendering-virtual bronchoscopy were not significantly different. Non-gated acquisition yielded significantly better visualization of the bronchial tree for both post-processing techniques, regardless of the time interval used for reconstruction of the ECG-gated series. Artifact scores in volume-rendered images were significantly higher for ECG-gated MDCT compared with nongated MDCT. Effective radiation dose was significantly higher for the ECG-gated acquisition. CONCLUSION: Given the advantage of volume rendering for representing the entire data set and given the lower radiation dose and better 3D image quality of nongated acquisition, volume rendering performed on nongated MDCT data is the method of choice for 3D visualization of the bronchial tree.

Bronchography↗
PubMed2004

MDCT in emergency radiology: is a standardized chest or abdominal protocol sufficient for evaluation of thoracic and lumbar spine trauma?

OBJECTIVE: The objective of our study was to assess the diagnostic performance of a standardized 4-MDCT trauma protocol for the evaluation of the thoracic and lumbar spine in patients with multiple injuries. MATERIALS AND METHODS: Eighty-two patients with multiple injuries underwent MDCT for the chest and abdomen using a standardized 4-MDCT trauma protocol (collimation, 4 x 2.5 mm). Secondary reconstructions targeted to the spine were performed (slice width, 3 mm; reconstruction interval, 1.5 mm). All spinal fractures were additionally scanned using a collimation of 4 x 1 mm, and these images served as the standard of reference for fracture classification. An additional 50 patients with no spinal fracture served as the control group. A total of 65 major spinal fractures were present in 55 of the patients with multiple injuries. Two observers (observer 1 and observer 2) independently evaluated all CT data for spinal fractures using a 5-point confidence scale, classified the different fracture types, and rated the image quality of spinal structures on axial images and multiplanar reformations. RESULTS: Image quality for axial images was excellent in 80% and in 68% using 4 x 1 mm and 4 x 2.5 mm collimation, respectively. Image quality of the multiplanar reformations was excellent in 75% and good in 65% using 4 x 1 mm and 4 x 2.5 mm collimation, respectively. Spinal fractures were detected by observer 1 and observer 2 with a sensitivity and specificity of 98% and 97% and of 97% and 97%, respectively. Interobserver agreement regarding the confidence scale for fracture detection was substantial (kappa = 0.80), and agreement between the different imaging protocols for fracture classification was excellent for observer 1 (kappa = 0.95) and observer 2 (kappa = 0.97). CONCLUSION: Accurate evaluation of the thoracolumbar spine is possible with targeted image reconstruction based on a standardized 4-MDCT trauma protocol of the chest and abdomen.

Adolescent↗
PubMed2003

Thin-section CT of the lung: does electrocardiographic triggering influence diagnosis?

PURPOSE: To determine the impact of prospective electrocardiographic (ECG) triggering on image quality and diagnostic outcome of thin-section computed tomography (CT) of the lung. MATERIALS AND METHODS: Forty-five consecutive patients referred for thin-section CT of the lung were examined with prospectively ECG-triggered and nontriggered thin-section CT of the lung with a multi-detector row helical CT scanner. Subjective image quality criteria (image noise, motion artifacts, and diagnostic accessibility) were rated by three radiologists in consensus for the upper lobe, middle lobe and/or lingula, and lower lobe. Pathologic changes were assessed for the various lobes, and a diagnosis was assigned. The diagnoses were compared by two radiologists in consensus to determine the effects of CT technique on diagnostic outcome. Quantitative measurements were performed, including determination of image noise and signal-to-noise ratios in different anatomic regions. The Wilcoxon signed rank test and paired sign test (both with Bonferroni correction) were used for statistical analysis. RESULTS: Subjective assessment showed significant differences in motion artifact reduction in the middle lobe, lingula, and left lower lobe. The diagnostic assessibility of triggered CT was rated significantly higher only for the left lower lobe compared with nontriggered data acquisition. No differences in diagnostic outcome were determined between triggered and nontriggered techniques. Mean image noise in tracheal air was 68.2 +/- 17 (SD) for triggered CT versus 37.4 +/- 9 for nontriggered CT (P <.05). Mean signal-to-noise ratio in the upper versus lower lobes was 22.5 +/- 8 versus 25.4 +/- 10 for triggered and 35.6 +/- 9 versus 39.2 +/- 10 for nontriggered techniques (P <.05). CONCLUSION: Given the lack of improvement in diagnostic accuracy and the need for additional resources, ECG-triggered thin-section CT of the lung is not recommended for routine clinical practice.

Adult↗
PubMed2003

Thymic medullary epithelial cell differentiation, thymocyte emigration, and the control of autoimmunity require lympho-epithelial cross talk via LTbetaR.

Thymocytes depend on the interaction with thymic epithelial cells for the generation of a diverse, nonautoreactive T cell repertoire. In turn, thymic epithelial cells acquire their three-dimensional cellular organization via instructive signals from developing thymocytes. The nature of these signals has been elusive so far. We show that thymocytes and medullary epithelial cells (MECs) communicate via the lymphotoxin beta receptor (LTbetaR) signaling axis. Normal differentiation of thymic MECs requires LTbetaR ligand on thymocytes and LTbetaR together with nuclear factor-kappaB-inducing kinase (Nik) in thymic epithelial cells. Impaired lympho-epithelial cross talk in the absence of the LTbetaR causes aberrant differentiation and reduced numbers of thymic MECs, leads to the retention of mature T lymphocytes, and is associated with autoimmune phenomena, suggesting an unexpected role for LTbetaR signaling in central tolerance induction.

Animals↗